Which factor would most worsen symptoms in children with sickle cell anemia?

• A. Dehydration
• B. Contracting viral and bacterial infections such as colds, the flu, and strep throat
• C. Routine exercise
• D. Balanced diet

Answer: (B)

When red blood cells sickle, anything that lowers oxygen delivery or thickens the blood can trigger more sickling and painful crises. Infections are especially impactful because they bring fever, inflammation, and often dehydration, all at once, which heightens the body's stress and can worsen anemia and pain. The fever increases metabolic demand and can impair oxygenation, tipping the balance toward more sickling and vaso-occlusion. Dehydration alone can worsen symptoms, but an infection stacks multiple stressors, making it more likely to worsen the child’s condition. Moderate routine exercise and a balanced diet support health and are not as likely to provoke these crises in the same way.